LCA

The Significance of Role Conflict and Ambiguity in Nursing

It doesn’t take a news report, or an online search to realize that the United States is facing a nursing shortage. Patients recognize it when their call light goes unanswered. Nurse’s see it because there’s not enough of them to answer all the lights that are on. The administrator knows because the next morning there is an AOR that states a patient fell trying to reach the bathroom, and no one answered his light. By the year 2022, the number of open nursing jobs will 1.05 million. One of the drivers of this shortage is nursing turnover. Forty-three percent of graduating nurses leave their first job in three years and even experienced nurses are turning over at an annual rate of fourteen percent ("American Association of the Colleges of Nursing," 2015). Administrators in health organizations are trying to turn these numbers around as it is a priority for the safety of staff and patients. Research has shown that role conflict and ambiguity are two of the leading causes of stress and poor work performance (Tunc & Kutanis, 2009). Role conflict exists when there is a conflict between two or more professional roles. Role ambiguity occurs because there is a lack of clarity surrounding the responsibilities of nursing duties (Moustaka & Constantinidis, 2010). For example, a new nurse may be given a larger that average caseload with some high acuity patients because the unit is short staffed. Role conflict happens because he is a new nurse thrown into the role of someone more experienced, and ambiguity because it is unclear how much responsibility he should accept. The result of this is work-related stress, decreased job satisfaction, occupational accidents and job errors (Moustaka & Constantinidis, 2010). It is no surprise that nurses are experiencing burnout and taking new jobs while some are leaving the profession altogether.

Literature : Negative Impact on Healthcare Organizations

Avoiding role conflict and ambiguity is vital for success within a healthcare organization. Both role conflict and ambiguity may negatively affect organization climate and the quality of care performed within healthcare organizations. Role clarity is imperative for maintaining quality healthcare outcomes (Roch, Dubois, & Clarke, 2014).Without role clarity confusion of job responsibilities may occur, which may lead to poor job performance or motivation. This in turn leads to negative organizational climate and healthcare related outcomes. According to the article, The Interactive effect of role conflict and ambiguity on job performance, research performed in a large organization in Israel revealed that both role conflict and role ambiguity lead to poor job performance (Fried, Ben-David, Tiegs, Avital, & Yeverechyahu, 1998). If role conflict and ambiguity persist burnout may occur in nurses. The lack of job role descriptions and expectations can develop burnout ( Tunc & Kutanis, 2009). High levels of nurse burnouts can result in high job turnover rates, leading to poor job performances and patient care outcomes. In a questionnaire study performed in a university hospital in Turkey, nurses experienced a high level of role conflict, ambiguity and burnout. This study revealed that role conflict and ambiguity may cause burnout, which diminish work performance, and put patients’ health at risk (Tunc & Kutanis, 2009). If healthcare organizations are expected to thrive in the nursing performance and patient care outcomes, it’s imperative that nurses are well informed of job responsibilities and requirements to avoid any negative effects on healthcare organizations.

Application to Nursing

Role conflict and ambiguity not only affects individual nurses, but it influences healthcare systems as a whole. O’Brien-Pallas et al. (2010) determined that role conflict and ambiguity is one of the causes for high staff turn-over rates and medication errors. High turn-over rates and medication errors incur a negative impact on the healthcare system in regards to revenue lost; according to National Survey Inc. (2015), hospitals lost 4.9 to 7.6 million dollars for one staff nurse. Negative patient outcomes and low patient satisfaction can be correlated to nurse turnover and nursing shortages caused by role conflict and ambiguity. Aiken, et al. (2002) studied staff burnout and turnover and how it affected patient outcomes; it was found that 23.2% of patients studied developed a major complication that was not related to their admission diagnosis, 2% of patients passed away within 30 days of discharge from the hospital. Negative patient outcomes and large revenue loss are strong drivers for healthcare systems to improve the relationships of their nursing staff and leadership.

In conclusion, role challenges have been reported for individuals who may be accustomed to working independently. Specifically, role ambiguity and role conflict have been associated with burnout; affecting both the general and special operators. As affirmed by the existing literature, role ambiguity is characterized by the employees’ failure to understand some of the roles that they are expected to perform, as well as the manner in which certain situations could be approached. On the other hand, role conflict results when an employee misunderstands and faces a dilemma regarding the perceptions and expectations of a role to be performed. Indeed, role conflict is attributed to the existence of two unrelated circumstances, with the affected persons playing more than one role that may overlap and lead to confusion. For instance, a mother may also be a manager. In such a case, she may wish to work late on some occasions but, at the same time, needs to attend to a young child. The dilemma is whether to play the role of a manager or a mother. The implication is that a majority of the current organizations ought to address the issues towards better outcome provision. On one hand, role conflict could be addressed by blowing off steam, sharing all the available information and analyzing various aspects of the conflict. On the other hand, role ambiguity could be addressed by clarifying the expectations, understanding the rewards and defining satisfactory performance, establishing priorities among the firms’ expectations, altering the values of outcomes, and redefining the roles to align them with the organization’s goals and objectives. Other approaches include participative decision-making, embracing cultural diversity and holding seminars and conferences from which platforms can be created to provide feedback. In summary, the solution to role conflict and ambiguity lies in collaborative efforts that entail top-down and bottom-up forms of communication in current organizations.